Approving funding to fight the Zika virus may be a slow-go in Congress — but Medicaid has let doctors know it covers two things that could combat the spread: bug repellent and contraception.

The program [Medicaid] can be used to cover mosquito repellent.

The Department of Health and Human Services told Medicaid providers in a memo last week the program can be used to cover mosquito repellent to prevent the spread of the Zika virus.

When prescribed by a health professional, the repellent would be eligible for Federal Financial Participation. The bug spray must include certain active ingredients such as DEET, icaridin, IR3535, oil of lemon eucalyptus, or paramenthanediol.

A spokesperson for Centers for Medicare and Medicaid Services said Medicaid covers repellent at each state’s discretion — and that new rules were not put in place to cover repellent because of Zika. They covered repellent before the memo was published.

But why bug repellent would be covered by insurance is a mystery to Dr. Lee Riley, an epidemiology and infectious disease professor at the University of California Berkeley. Things are no different now than when the West Nile epidemic was happening, he told LifeZette — and added that mosquito control should be done by cities and county governments.

“It’s cheap,” Riley said of bug spray. “People who can’t afford it won’t be traveling abroad anyway.”

Others feel the memo indicates CMS is at least taking Zika seriously.

“They’re telling doctors that this is very important,” said Dr. Jose Szapocznik, a professor and public health researcher with the University of Miami Health System. He supports free bug repellent because it would lessen the likelihood of an epidemic.

If a patient requests it, denying it to them would put the patient at risk and means the doctor would not be compliant with Medicaid’s standard of care.

“The hairs on the back of my neck stand up anytime I hear Medicaid is paying for a service or item that may be deemed optional,” said one patient advocate.

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“I wouldn’t want to be that doctor [who refuses to prescribe it],” Szapocznik said.

Kiki Rogers, who owns MN Advocates for Patients, a patient advocacy group in Rogers, Minnesota, said Medicaid tends to be lenient on the coverage guidelines with regard to Medicare and commercial insurance plans.

“As a personally and fiscally conservative individual, the hairs on the back of my neck stand up anytime I hear Medicaid is paying for a service or item that may be deemed optional,” Rogers said.

She also understands the risks. “Without that coverage, these families are at greater exposure to potential illness such as Zika virus,” she said.

Cost Savings
While people in northern regions of the country may not require it, bug repellent could be a good way for low-income families in the South to protect themselves, said Dr. Ryan Stanton. The emergency room physician in Lexington, Kentucky, and a spokesperson for the American College of Emergency Physicians said the virus isn’t just about a one-time illness — it could produce another human with expensive, long-term complications.

But they have to take other precautions, too, because applying spray isn’t enough. Wearing ample clothing, avoiding being outside during dawn and dusk, and emptying containers of rainwater is important.

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“We also need to make sure everybody does the common-sense stuff,” he said. Stanton said pregnant women should not travel to endemic areas; if so, they are just “asking for an issue or complication.”

The cost to taxpayers for funding Medicaid-issued bug spray now is much less than a nation caring for children with microcephaly and other nervous system complications later.

“We don’t know if it’s going to spread,” said Stanton, adding that prevention is imperative due to the time of year and ever-changing information emerging about the virus.

Bypassing Congress
The move comes as congressional lawmakers spar over funding: The White House has already moved roughly $500 million from its Ebola virus fund to respond to Zika. The Senate passed a $1.1 billion bill for mosquito extermination, testing, and vaccine research, and the House has authorized $622 million that includes rerouting money previously dedicated to Ebola, USA Today reported.

The memo also reminded providers of family planning counseling and contraceptives, which can be used to prevent the spread of the virus. States can also use optional diagnostic and screening Medicaid services for adults. They are required to cover all medically necessary services, including diagnosis of microcephaly and other birth defects, to people under the age of 21.